Remember your residency family

 From the 6/11/2021 newsletter

Guest Director's Column

Remember your residency family

  

 Alicia Pilarski, DO

Kathlyn E. Fletcher, MD MA

 

 Doctors Alicia Pilarski and Kathlyn Fletcher share with today’s residents how their own experiences during residency led to lifelong, supportive, and important relationships.

  

From Dr. Fletcher:

 June is a time filled with so much nostalgia and excitement.  There are so many endings in June.  But of course, endings almost always make room for beginnings. This weekend, I (KF) had a Zoom call with members of the graduating class of 1996 from the University of Chicago’s Pritzker School of Medicine.  How can it have been twenty-five years since I graduated?  But that ending made way for the beginning of my residency which would ultimately become the most formative years of my professional life.  

I remember snippets of my own intern orientation week. In one particular memory, I was sitting on the 7^th floor of the hospital in the Internal Medicine residents’ respite area.  I was in the room that I would go to daily for three next years for morning report.  On that day, I looked around at my class of twenty-five interns, eight of whom had graduated from medical school with me and four of whom were my closest friends of the past four years.  We were doing an ice breaker meant to help us get to know each other, and I thought to myself, “Why am I doing this?  I already have plenty of friends in this program.”  Clearly, I had a lot to learn about the village needed to get me through residency.

Those four people remained close friends throughout residency and beyond; in fact, two of them were at my 50^th birthday party last year.  However, many of the others profoundly influenced me as well.  To call those who walk beside you through residency “friends” seems to be a gross underrepresentation of the role they play.  Co-residents are very much like siblings.  They are part of the daily rhythm of life.  They also bear witness to extraordinarily difficult moments, days, weeks.  My own co-residents ate ice cream with me when I needed it even when they didn’t (thanks Reggie!), patiently double checked my calculation of the rate of hypertonic saline for an obtunded hyponatremic patient in the ICU (thanks Jeff!), and cried with me for patient and other losses during those three years (thanks Erin!).  They debriefed, advised, bolstered, and encouraged.  They were my family.

 

From Dr. Pilarski:

 I (AP) had an incredibly similar experience to Dr. Fletcher during my time in residency. The highest highs and the lowest lows were shared with my seven other Emergency Medicine (EM) residents. Getting my first solo intubation during a code on the floor and celebrating with a margarita that night (thanks, Peter!), late nights in the Trauma ICU trying to keep our sickest patients alive (thanks, Troy!), and experiencing my first medical error and having my co-chief there to help support me through it (thank you, Josh!).

One of my fondest memory was when we created a calendar of photos that we gifted to our faculty and the ED nurses upon graduation. Clearly, we believed our faculty and nurses would always remember us as the “best” EM residency class, and so we felt it was our responsibility to remind them of that fact for at least the next year. We staged photos in various locations throughout the hospital and around town, many of which resulted in hysterical situations and additional photos that were deemed “too inappropriate” for the final product. At the end of the day, our faces hurt from smiling and laughing so hard. But then it became very real that our time together was ending, and in a few short days we would be spread out across the country in new emergency departments. I tried to manage the excitement about the next chapter in my career with the immense sadness I was feeling from being separated from my residency family that I had formed such a unique and special bond with over the past three years. I worried that the bond we had created would be lost to distance, new colleagues, busy schedules, or elapsed time. But I knew it was time to move on for all of us. 

We stayed in touch for the first year via text and then, slowly, our chats became less frequent. It was bound to happen, right? But then, COVID hit. And on March 16, 2020, our first group text in several years started that bond all over again: “Checking in with all of you. We are just starting to get hit with COVID. Thinking of all of you and hope you are all staying healthy.” What followed were numerous texts about our fears and anxieties, what each of our respective EDs and hospital systems were doing, what PPE we had, how we would decontaminate after a shift, how we planned to keep our families safe, and what we knew about this novel virus. And then we shared pictures of our kids, dogs, ourselves in N95s and CAPRs, and other funny pictures from when we were in residency (including some from that calendar we made!). And those texts continued through the year and into this year. They are now more focused on celebratory messages and pictures of things like vacations and group photos with friends.

We had gone through another immensely stressful, challenging, and formative phase of our lives again. What I came to realize was that distance, new jobs, busy lives and time did not break that bond. It was always there this whole time, and it was stronger than I could have ever imagined.

 

In this issue of the Transformational Times, we hear from three graduating residents who tell their stories of the formative experiences of residency, what they learned and what they hope to carry forward.  Like all of us who persevered through residency (or another professional equivalent), they had personal journeys marked by small and big moments.  We also hear from Dr. Ken Simons, who leads the GME enterprise at Medical College of Wisconsin Affiliated Hospitals.  He offers a poignant reflection on the last sixteen months and how that time has shaped the worldviews of all of us, especially the residents.  Finally, Dr. Eric Holmboe, from the Accreditation Council of Graduate Medical Education, offers additional insight into what to carry forward from residency.  There is even a piece of original artwork for you to contemplate.  We hope that you enjoy it!

To all the graduating residents across MCWAH, we are incredibly grateful for your work during residency.  You have healed patients, listened to families, taught students, comforted each other, and grown personally and professionally.  Whether you believe it or not, you are ready for this ending and the beginning that follows it.  Remember your residency family and lean on them when you need to.  Know that many people are proud of you and believe in you.  We can’t wait to see how you move our profession toward the ideal we all know is possible.   

 

Alicia Pilarski, DO is an Associate Professor of Emergency Medicine, Associate Chief Medical Officer of Froedtert Hospital, Co-Pillar Director for Kern Institute GME Pillar, Co-Medical Director for the F&MCW “Supporting our Staff” Peer Support Program.

 

Kathlyn E. Fletcher, MD MA is a Professor and residency program director in the Department of Medicine at MCW. She is the co-Director of the Graduate Medical Education Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.